Went to the workshop in the morning and finished off standing frames # 3&4. I also trained Jose how to label the standing frames with the new serial number system which includes the first letter of the country the first letter of the city of the shop as well as the number that shop has produced. Here in Lima Peru with the serial number will be PL – 1 etc. signifying the first standing frame that was made in Lima. This system is born out of necessity to keep track of production locations and quality. I also showed him how to use the Google drive document recording all produced standing frames from around the world. We have a quick breakfast together with Julia and then Julie and I went to her church in downtown Lima. Sermon was about Darius the king of Babylon’s decree to allow for the rebuilding of the temple I Jerusalem and how after they built the temple they consecrated it. This remarkably relates to what we are doing here in Peru, we have now built our workshop and now we set it apart for the glory of God.
We then picked up Daniella, Julia’s daughter, and had Burger King for lunch on the way to experience an afternoon with Julia where she volunteers as an interpreter for individuals who are both blind and deaf at their weekly reunion. It was quite a learning experience for me not only learning some sign language, but also learning about tactile transmission of language. I even made a few new friends Eugenio and Eleira!
At the workshop with Jose we were able to completely finish 2 standing frames in the morning. And the other two are within an hour or so of being finished. It is great to watch as Jose learns and begins taking ownership of the steps involved in the process. He has a lot of experience as a carpenter and has made several good suggestions, including devising a way to ensure the backboard and the stability beam are parallel. While we were working, Evelyn walked by who is a neighbor from a block down the street. Jose introduced me to her to me because she has an 8 year old son named Yamil who has cerebral palsy. About 3 months ago Jose tried to make Yamil a standing contraption from his own exercise equipment. The stander he made functions in the sense that Yamil is able to get upright, but was not very comfortable or useful in practice because it did not have good support in areas that Yamil required. It was the best he could do with limited knowledge about cerebral paslsy and the purposes of standing therapy, and a noble effort at that. I drove down the street, and picked Yamil up and drove him to the shop. He promptly became the first child to use our newly constructed frames, before they even left the workshop! I told them we had a scheduled therapist training session at Qumi at 3:30pm and they agreed to come as example patients. So we all headed over to Qumi with myself and standing frames in the back seat, and Jose, Evelyn and Yamil all upfront.
The therapist session was amazing. With 2 standing frames and 2 patients and their mothers, 2 physical therapist, an occupational therapist an emotional therapist, myself and Jose we reviewed the benefits, indications, and contraindications a of standing therapy. Then Julia and I summarized the missions of SWM and LMR and the goals for the standing frame collaboration. I introduced our system of forms that help is keep track of patients and information. Then we practiced filling out the new patient form together with the therapists for each patient. We then got the patients to the standing frame. It was great because Yamil is at the taller end of the frames capacity, and Alexander (age 1yr 9 m) is on the smaller end, so we really showed off the adaptability of our stander and the therapist got to practice fitting the children to the frame.
Story of Alexander: About 2.5 months ago Alexander’s mother asked their physical therapist Maritza, where she could get a standing frame for Alexander. Maritza didn't know anywhere they were available, so she then asked Mesa del Reino if they knew anywhere standing brand could be purchased or found in Lima. Nobody knew. They decided to pray about it not knowing what else do do. Just five days later is when they received the email from Stand With Me offering to come to Lima and help make standing frames. How fitting that Alexander his mother and their PT Maritza could all be there and receive one of the first standing frames made in Lima. Alexanders mother did a brief interview about our standing frame, how difficult it is to find one in Lima and how much better ours is then the one she was able to have built just before our arrival. I will post the video as soon as I have a chance to translate it.
Both children went home and now have their own standing frame in their house that their mothers are excited about and that will provide them adequate support to to proper standing therapy at home.
Rented a truck for 25 Soles (~$7) to take the plywood parts and the wooden beams from Qumi to the workshop. We began by sanding all of the parts. The shop was full of helpers today with Julia, Jose the lead carpenter, and his students Pedro, Carlos and Israel. With so many hands, the work went quickly and was very enjoyable..We had lunch at Jose’s house across the street from the factory, a delicious fried rice with hand squeezed lime aid prepared by Jose’s mother.
Carlos took me to a pair supply shop about 2 blocks away where we purchased the wood sealer and applicator cloths. Applying sealer to the wood is a multi step labor intensive process, but again with division of labor and many helpers we had 4 standing frames worth of material applied with 2 coats of sealant and a finishing coat of varnish applied and sanded down by 4:30pm. In total the standing frame is sanded 4 times thoroughly. This produces a wood that is robust and resistant to the elements and free of splinters making it safe for use with children. From there we went through the major assemblies including the footrest, tray table and attaching the backboard to the supporting beams. We were able to finish the major components of one standing frame today, and will wrap up the other three tomorrow morning. We took our time with the first assembly as I wanted to make sure that they understand the process and have the opportunity to ask questions. This is the see one, do one teach one model. All day Julia helped me along with Rodrigo (LMR helper with Tourette’s syndrome) by taking meticulous pictures of each step in the production process which will be included in our upcoming SWM Production Manual (Version 2).
Jose took Julia and I to La Punta, which is a point just a few blocks wide sticking West out into the Pacific Ocean. I invited them to dinner and we had Anticucho or grilled cow heart. It is one of my favorite Peruvian dishes.
We loaded the extra plywood from Qumi into Jose’s car for him to take to the factory for use in other projects.
Today Julia Carlos and I already bought ourselves with making the plywood parts at the CNC machine. We departed around 10 AM from LMR and drove about 30 minutes to the CNC machine shop. We met with the boss there, and went with one of his helpers to go purchase plywood from a shop down the road riding in a Tuk-Tuk. I decided to buy two different kinds of plywood, one pine, and the other local tree I was unfamiliar with. We planned to make two standing frames from each and compare outcomes. We strapped the two 2x8 foot prices of plywood to the roof of a taxi and headed back to the CNC shop. It took about 4 hours to cut the parts out, but in the end everything came out beautifully and we managed to sneak lunch in at a nearby mall. All the fresh cut parts fit easily into our car, the extra pieces of plywood that we are saving took a little bit of extra coaxing but entered eventually. We deposited all the plywood at LMR in preparation for tomorrow’s production. I have now learned the bus system and got myself home without an escort from LMR staff. Starting to feel at home here in Lima.
Mission Essential Goals for Peru:
From breakfast we set out to the nearby woodworking shop run by Jose Luis called “Capacitados”, which means “The Capable”, and is a workshop where he trains people with various disabilities carpentry to the level of their ability. Capacitados will be our primary production facility for the moment and the students will be intimately involved in the production of the standing frames. I took the opportunity to explore the shop and verified that the shop already had all necessary equipment to assemble the standing frames and had a chance to discuss with Jose Luis information about the upcoming production. We are ready to begin as soon as tomorrow afternoon!
From the Capacitados workshop, Julia and I proceeded to Prite Callao which is a school for over 180 children with disabilities of all kinds. The director Yerika Villanueva showed us around the school which has 7 private therapy rooms decked out with colorful toys and learning tools. We had heard that Prite Callao had received a SWM standing frame about 2 years ago from our shop in Arequipa, Peru (south of lima 17 hr drive) however it turns out that was not the case. Yerika showed us two non-SWM standing frames that they have in their clinic, neither of which is very useful due to the poor adjustability or lack of support provided. When we showed her and some of the Prite Callao therapists pictures of our standing frame they became very excited and exclaimed, “this is exactly what we have been hoping and looking for”. We set up two sessions at their center for early next week to train their whole therapy staff in the use of standing therapy and the SWM standing frame.
Next we headed over to La Mesa del Reino’s facilities named “Qumi”. There we began contacting local CNC shops that we will use to cut out the plywood parts of or standers. I turns out that Julia is also a graphic designer so she has the computer program and skills to make edits to the standing frame CNC files at LMR, so we don’t have to pay an engineer to make the changes. So we set about editing the computer files to reflect the most recent updates to the design based on feedback from Guatemala earlier this week.
In the evening I went with Juan Marcos to the local Sodimac, the Peruvian equivalent of Home Depot, and we purchased the 2x4 and 2x3 planks. Those combined with the hardware and items I brought from Guatemala combine so that we now have all the materials required for the batch of 4 standers.
Finally, 9 staff and patients from LMR and myself went out to a rotisserie chicken dinner as a team to get to know each other. This group of people are extremely talented and driven to help improve the lives of people with disabilities. It is now midnight, and I am exhausted, but satisfied with the immense progress that we made today. We are even slightly ahead of schedule. I cannot believe how smoothly things are going. It is incredible to see how god provides.
I arrived uneventfully after a 17 hr travel day to the Aurora International Airport in Guatemala City and managed to pick up my rental car and get to the factory by 1 am. Was greeted by Mark Richard (director of Beeline Wheelchairs), Micah (Beeline administrator) and a visiting nurse around 7 am at the factory and we had a nice breakfast of eggs, beans and cantaloupe. I then had a chance to meet up with Pedro who is our new standing frame carpenter. We spent the morning reviewing his suggestions about the design, production and distribution, then we did a little practice together working out how to most efficiently make the backboards. We headed to lunch in San Lucas about 10 mins down the road from the factory and had a chance to relax and get some pizza. After lunch we set about making a new set of jigs which will improve the efficiency of standing frame production. So far we have begun the most complex jig which connects the legs of the stander to the backboard. This jig is very large and must be very precise so that the stander is not wobbly while the child uses it.